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Public Health Statement for Aluminum

This Public Health Statement is the summary chapter from the Toxicological
Profile for Aluminum. It is one in a series of Public
Health Statements about hazardous substances and their health
effects. A shorter version, the ToxFAQs™,
is also available. This information is important because this substance may harm you. The effects of exposure to any hazardous substance depend on the dose, the duration, how you are exposed, personal traits and habits, and whether other chemicals are present. For more information, call the ATSDR Information Center at 1-800-232-4636.

This public health statement tells you about aluminum and the effects of exposure to it.

The Environmental Protection Agency (EPA) identifies the most serious hazardous waste sites in the nation. These sites are then placed on the National Priorities List (NPL) and are targeted for long-term federal clean-up activities. Aluminum (in some form, e.g., in compounds with other elements such as oxygen, sulfur, or phosphorus) has been found at elevated levels in at least 596 of the 1,699 current or former NPL sites. Although the total number of NPL sites evaluated for this substance is not known, the possibility exists that the number of sites at which aluminum is found may increase in the future as more sites are evaluated. This information is important because these sites may be sources of exposure and exposure to this substance at high levels may be harmful.

When a substance is released either from a large area, such as an industrial plant, or from a container, such as a drum or bottle, it enters the environment. Such a release does not always lead to exposure. You can be exposed to a substance only when you come in contact with it. You may be exposed by breathing, eating, or drinking the substance, or by skin contact. However, it should be noted that aluminum is a very abundant and widely distributed element and will be found in most rocks, soils, waters, air, and foods. You will always have some exposure to low levels of aluminum from eating food, drinking water, and breathing air.

If you are exposed to aluminum, many factors will determine whether you will be harmed. These factors include the dose (how much), the duration (how long), and how you come in contact with it. You must also consider any other chemicals you are exposed to and your age, sex, diet, family traits, lifestyle, and state of health.

1.1 What is aluminum?

Description

Aluminum is the most abundant metal in the earth's
crust and it is widely distributed.

Aluminum is a very reactive element and is never found as the free metal
in nature. It is found combined with other elements, most commonly with
oxygen, silicon, and fluorine. These chemical compounds are commonly
found in soil, minerals (e.g., sapphires, rubies, turquoise), rocks
(especially igneous rocks), and clays.

Aluminum as the metal is obtained from aluminum-containing minerals,
primarily bauxite.

Aluminum metal is light in weight and silvery-white in appearance.

Uses

Aluminum metal

Aluminum is used to make beverage cans, pots and pans, airplanes, siding and roofing, and foil.

Powdered aluminum metal is often used in explosives and fireworks.

Aluminum compounds

Aluminum compounds are used in many diverse and important industrial applications such as alums (aluminum sulfate) in water-treatment and alumina in abrasives and furnace linings.

An average adult in the United States eats about 7–9 mg of aluminum per
day in their food.

Air

Most people take in very little aluminum from
breathing. Levels of aluminum in the air generally range from 0.005 to
0.18 micrograms per cubic meter (ìg/m3), depending on location, weather
conditions, and type and level of industrial activity in the area. Most
of the aluminum in the air is in the form of small suspended particles
of soil (dust).

Aluminum levels in urban and industrial areas may be higher and can
range from 0.4 to 8.0 ìg/m3.

People generally consume little aluminum from drinking water. Water is
sometimes treated with aluminum salts while it is processed to become
drinking water. But even then, aluminum levels generally do not exceed
0.1 mg/L. Several cities have reported concentrations as high as 0.4–1
mg/L of aluminum in their drinking water.

Consumer Products

People are exposed to aluminum in some cosmetics,
antiperspirants, and pharmaceuticals such as antacids and buffered
aspirin.

Antacids have 300–600 mg aluminum hydroxide (approximately 104–208 mg
of aluminum) per tablet, capsule, or 5 milliliter (mL) liquid dose.
Little of this form of aluminum is taken up into the bloodstream.

Buffered aspirin may contain 10–20 mg of aluminum per tablet

Vaccines may contain small amounts of aluminum compounds, no greater
than 0.85 mg/dose.

1.5 How can aluminum affect my health?

Workers who breathe large amounts of aluminum dusts
can have lung problems, such as coughing or changes that show up in
chest X-rays. The use of breathing masks and controls on the levels of
dust in factories have largely eliminated this problem.

Some workers who breathe aluminum-containing dusts or aluminum fumes
have decreased performance in some tests that measure functions of the
nervous system.

Humans

Oral

Oral exposure to aluminum is usually not harmful. Some
studies show that people exposed to high levels of aluminum may develop
Alzheimer’s disease, but other studies have not found this to be true.
We do not know for certain that aluminum causes Alzheimer’s disease.

Some people who have kidney disease store a lot of aluminum in their
bodies. The kidney disease causes less aluminum to be removed from the
body in the urine. Sometimes, these people developed bone or brain
diseases that doctors think were caused by the excess aluminum.

Although aluminum-containing over the counter oral products are
considered safe in healthy individuals at recommended doses, some
adverse effects have been observed following long-term use in some
individuals.

Laboratory animals

Inhalation

Lung effects have been observed in animals exposed to aluminum dust. Scientists do not know if these effects are due to the aluminum or to the animals breathing in a lot of dust.

Oral

Studies in animals show that the nervous system is a sensitive target of aluminum toxicity. Obvious signs of damage were not seen in animals after high oral doses of aluminum. However, the animals did not perform as well in tests that measured the strength of their grip or how much they moved around.

1.6 How can aluminum affect children?

This section discusses potential health effects in humans from exposures during the period from conception to maturity at 18 years of age.

Effects in children

Brain and bone disease caused by high levels of
aluminum in the body have been seen in children with kidney disease.
Bone disease has also been seen in children taking some medicines
containing aluminum. In these children, the bone damage is caused by
aluminum in the stomach preventing the absorption of phosphate, a
chemical compound required for healthy bones.

Aluminum is found in
breast milk, but only a small amount of this aluminum will enter the
infant’s body through breastfeeding. Typical aluminum concentrations in
human breast milk range from 0.0092 to 0.049 mg/L. Aluminum is also
found in soy-based infant formula (0.46–0.93 mg/L) and milk-based infant
formula (0.058–0.15 mg/L).

Birth defects

We do not know if aluminum will cause birth defects in
people. Birth defects have not been seen in animals.

Very young
animals appeared weaker and less active in their cages and some
movements appeared less coordinated when their mothers were exposed to
large amounts of aluminum during pregnancy and while nursing. In
addition, aluminum also affected the animal’s memory. These effects are
similar to those that have been seen in adults.

It does not appear that children are more sensitive than adult
animals.

1.7 How can families reduce the risk of
exposure to aluminum?

You cannot avoid exposure to aluminum because it is so
common and widespread in the environment.

Exposure to the levels of
aluminum that are naturally present in food and water and the forms of
aluminum that are present in dirt and aluminum pots and pans are not
considered to be harmful.

Eating large amounts of processed food containing aluminum additives
or frequently cooking acidic foods in aluminum pots may expose a person
to higher levels of aluminum than a person who generally consumes
unprocessed foods and uses pots made of other materials (e.g., stainless
steel or glass). However, aluminum levels found in processed foods and
foods cooked in aluminum pots are generally considered to be safe.

Consumer products

Limiting your intake of large quantities of
aluminum-containing antacids and buffered aspirin and using these
medications only as directed is the best way to limit exposure to
aluminum from these sources.

As a precaution, such products should
have child-proof caps or should be kept out of reach of children so that
children will not accidentally ingest them.

1.9 What recommendations has the federal
government made to protect human health?

The federal government develops regulations and recommendations to protect public health. Regulations can be enforced by law. The EPA, the Occupational Safety and Health Administration (OSHA), and the Food and Drug Administration (FDA) are some federal agencies that develop regulations for toxic substances. Recommendations provide valuable guidelines to protect public health, but cannot be enforced by law. The Agency for Toxic Substances and Disease Registry (ATSDR) and the National Institute for Occupational Safety and Health (NIOSH) are two federal organizations that develop recommendations for toxic substances.

Regulations and recommendations can be expressed as “not-to-exceed” levels, that is, levels of a toxic substance in air, water, soil, or food that do not exceed a critical value that is usually based on levels that affect animals; they are then adjusted to levels that will help protect humans. Sometimes these not-to-exceed levels differ among federal organizations because they used different exposure times (an 8-hour workday or a 24-hour day), different animal studies, or other factors.

Recommendations and regulations are also updated periodically as more information becomes available. For the most current information, check with the federal agency or organization that provides it. Some regulations and recommendations for aluminum include the following:

Drinking water

The EPA has recommended a Secondary Maximum Contaminant Level (SMCL) of 0.05–0.2 mg/L for aluminum in drinking water. The SMCL is not based on levels that will affect humans or animals. It is based on taste, smell, or color.

Consumer products

The FDA has determined that aluminum used as food
additives and medicinals such as antacids are generally safe.

FDA set
a limit for bottled water of 0.2 mg/L.

Workplace air

OSHA set a legal limit of 15 mg/m3 (total dust) and 5
mg/m3 (respirable fraction) aluminum in dusts averaged over an 8 hour
work day.

ATSDR can also tell you the location of occupational and environmental health clinics. These clinics specialize in
recognizing, evaluating, and treating illnesses resulting from exposure to hazardous substances.

Information line and technical assistance:
Phone: 888-422-8737

To order toxicological profiles, contact:
National Technical Information Service
5285 Port Royal Road
Springfield, VA 22161
Phone: 800-553-6847 or 703-605-6000

Disclaimer
Some PDF files may be electronic conversions from paper copy or other electronic ASCII text files. This conversion may have resulted in character translation or format errors. Users are referred to the original paper copy of the toxicological profile for the official text, figures, and tables. Original paper copies can be obtained via the directions on the toxicological profile home page, which also contains other important information about the profiles.

The information contained here was correct at the time of publication. Please check with the appropriate agency for any changes to the regulations or guidelines cited.